Gambling and Youth Gambling and Youth Gambling IssuesGambling Issues
Presentation to Value Options EAP Presentation to Value Options EAP ProfessionalsProfessionals
July 24, 2008July 24, 2008
Keith Whyte, Executive DirectorKeith Whyte, Executive DirectorNational Council on Problem GamblingNational Council on Problem Gambling
About NCPGAbout NCPGThe national advocate for people The national advocate for people
affected by problem gambling.affected by problem gambling. NEUTRAL on legalized gambling.NEUTRAL on legalized gambling. Founded in 1972.Founded in 1972. National grassroots non-profit with National grassroots non-profit with
chapters in 36 of 50 states.chapters in 36 of 50 states. Work with government, gaming Work with government, gaming
industry & community.industry & community.
Core ProgramsCore Programs
National Helpline Network National Helpline Network (800.522.4700) (800.522.4700)
Nat’l Problem Gambling Awareness WeekNat’l Problem Gambling Awareness Week Annual Conference on Problem Gambling Annual Conference on Problem Gambling
Prevention, Treatment, Research & Prevention, Treatment, Research & Recovery (June 25-27, 2009, Indianapolis)Recovery (June 25-27, 2009, Indianapolis)
Public Awareness & MediaPublic Awareness & Media Certification AdministrationCertification Administration ADVOCACY!ADVOCACY!
Key Issues and Trends In:Key Issues and Trends In:
Gambling Today—Scope, Gambling Today—Scope, Participation & RevenueParticipation & Revenue
Problem Gambling—Definitions, Problem Gambling—Definitions, Prevalence, Risk Factors, Co-Prevalence, Risk Factors, Co-Occurring Disorders & Service Occurring Disorders & Service DeliveryDelivery
Focus on Youth GamblingFocus on Youth Gambling
Section I: GamblingSection I: Gambling
Scope, Participation & Scope, Participation & RevenueRevenue
What Is Gambling?What Is Gambling? Gambling is risking something of value on an Gambling is risking something of value on an
uncertain outcome. uncertain outcome. One of the oldest human behaviors, indeed, One of the oldest human behaviors, indeed,
an apt description for most human activity. an apt description for most human activity. 3 Prong Test: Prize, Chance, Consideration3 Prong Test: Prize, Chance, Consideration In the US, gambling is generally illegal In the US, gambling is generally illegal
unless a specific form has been specifically unless a specific form has been specifically legalized by government.legalized by government.
Legal in 48 states—what are the 2 without? Legal in 48 states—what are the 2 without? UtahUtah HawaiiHawaii
Are We a Nation of Are We a Nation of Gamblers?Gamblers?
Ever Gambled? 85%Ever Gambled? 85% Gambled in the Past Year? 65%Gambled in the Past Year? 65% Gambled at least weekly? 15%Gambled at least weekly? 15% But 35% of Americans believe that But 35% of Americans believe that
“gambling is morally wrong!”“gambling is morally wrong!” 1818thth century moral mindset & laws v. century moral mindset & laws v.
2121stst century entertainment & century entertainment & technologytechnology
Adult (18+) Risky Behaviors: Adult (18+) Risky Behaviors: Smoking, Gambling & DrinkingSmoking, Gambling & Drinking
Past yearPast year LifetimeLifetime
Tobacco UseTobacco Use 35%35% 71%71%
Alcohol UseAlcohol Use 64%64% 82%82%
GamblingGambling 65%65% 85%85%
2006 Gaming NM & US2006 Gaming NM & USNMNM USUS NM RevNM Rev US RevUS Rev
CasinosCasinos 2121 838399
$238 $238 millionmillion
$47.8 $47.8 billionbillion
RacingRacing 55 121233
$36.8 $36.8 millionmillion
$4.5 billion$4.5 billion
LotteryLottery 11 3737 $73.4 $73.4 millionmillion
$25.1 $25.1 billionbillion
CharitablCharitablee
?? ?? $12 million$12 million $1.5 billion$1.5 billion
TOTALTOTAL 2828 999999
$360 $360 millionmillion
$79 billion$79 billion
Legal Gambling Revenue Legal Gambling Revenue ($billions)($billions)
27
95
$0
$20
$40
$60
$80
$100
$120
$140
$160
$180
1998 2008 2018
To DateProjected
Trends & Issues:Trends & Issues:
Convergence of types of gambling.Convergence of types of gambling. Games become faster, more Games become faster, more
interactive, higher limits.interactive, higher limits. When will gaming participation and When will gaming participation and
revenues peak? Is there a saturation revenues peak? Is there a saturation point? point?
Will states and tribes continue to Will states and tribes continue to expand gambling? expand gambling?
Section II: Problem Section II: Problem GamblingGambling
Definitions, Prevalence, Risk Definitions, Prevalence, Risk Factors, Co-Occurring Factors, Co-Occurring
Disorders & Service DeliveryDisorders & Service Delivery
Working DefinitionsWorking Definitions Problem gambling: “Any gambling Problem gambling: “Any gambling
behavior that causes harm to the behavior that causes harm to the gambler or their family.”gambler or their family.” Gambler does NOT meet current clinical Gambler does NOT meet current clinical
criteria.criteria. Pathological gambling: “Severe and Pathological gambling: “Severe and
persistent problems with gambling persistent problems with gambling behavior, a serious mental health behavior, a serious mental health disorder.”disorder.” Gambler meets clinical criteria.Gambler meets clinical criteria.
Screening ToolsScreening Tools
NODS (NORC Diagnostic Screen)NODS (NORC Diagnostic Screen) CPGI (Canadian Problem Gambling CPGI (Canadian Problem Gambling
Index)Index) SOGS (South Oaks Gambling Screen)SOGS (South Oaks Gambling Screen) GA 20 (Gamblers Anonymous 20 GA 20 (Gamblers Anonymous 20
Questions)Questions) Lie/Bet ScreenLie/Bet Screen
10 Questions DSM IV10 Questions DSM IV You have often gambled longer You have often gambled longer
than you had planned.than you had planned. You have often gambled until your You have often gambled until your
last dollar was gone.last dollar was gone. Thoughts of gambling have caused Thoughts of gambling have caused
you to lose sleep.you to lose sleep. You have used your income or You have used your income or
savings to gamble while letting bills savings to gamble while letting bills go unpaid.go unpaid.
You have made repeated, unsuccessful You have made repeated, unsuccessful attempts to stop gambling.attempts to stop gambling.
You have broken the law or considered You have broken the law or considered breaking the law to finance your breaking the law to finance your gambling.gambling.
You have borrowed money to finance You have borrowed money to finance your gambling.your gambling.
You have felt depressed or suicidal You have felt depressed or suicidal because of your gambling losses.because of your gambling losses.
You have been remorseful after You have been remorseful after gambling.gambling.
You have gambled to get money to You have gambled to get money to meet your financial obligations.meet your financial obligations.
If you or someone you know If you or someone you know answers yes to any of these answers yes to any of these questions, consider seeking questions, consider seeking assistance from a professional assistance from a professional regarding this gambling behavior. regarding this gambling behavior.
Call 800.522.4700: Confidential & Call 800.522.4700: Confidential & toll free, 24/7-there is help and toll free, 24/7-there is help and hope available.hope available. Questions developed by NCPG from Questions developed by NCPG from
DSM-IV criteria. Probable pathological DSM-IV criteria. Probable pathological gamblers score 5+. Probable problem gamblers score 5+. Probable problem gamblers score 1-4.gamblers score 1-4.
Lie/Bet ScreenLie/Bet Screen Have you ever felt the need to bet Have you ever felt the need to bet
more and more money?more and more money? Have you ever had to lie to people Have you ever had to lie to people
important to you about how much important to you about how much you gambled?you gambled?
Yes to one or both classifies Yes to one or both classifies respondent as a pathological gamblerrespondent as a pathological gambler Johnson, et al, (1997) Psychological Johnson, et al, (1997) Psychological
ReportsReports
Problem Gambling RatesProblem Gambling Rates
In the past year, approximately 1% In the past year, approximately 1% of adults (3 million) meet criteria of adults (3 million) meet criteria for pathological gambling.for pathological gambling.
Past year, approximately 2-3% (6 Past year, approximately 2-3% (6 to 9 million) adults meet criteria to 9 million) adults meet criteria for problem gambling.for problem gambling.
Prevalence IssuesPrevalence Issues
States with stable or decreased rates States with stable or decreased rates had relatively larger PG programs.had relatively larger PG programs.
Gaming revenue, type of gambling, Gaming revenue, type of gambling, # of EGMs, proximity to venue, etc…# of EGMs, proximity to venue, etc…likely important but relationship likely important but relationship unclear. unclear.
No significant regional differences.No significant regional differences.
Bio-Psycho-Social Risk Bio-Psycho-Social Risk FactorsFactors
MaleMale AthleteAthlete 18-24 Yrs18-24 Yrs Substance useSubstance use Substance abuseSubstance abuse Other MH problemOther MH problem Family history of Family history of
addictionaddiction
Low SESLow SES Military ServiceMilitary Service Racial/Ethnic Racial/Ethnic
minorityminority Gamble illegallyGamble illegally Early onsetEarly onset Early big winEarly big win Easy access to Easy access to
gamblinggambling
Biological/Environmental Biological/Environmental FactorsFactors
Self controlledSelf controlled ImpulsiveImpulsiveRisk aversiveRisk aversive Prone to take risksProne to take risksPredisposed toPredisposed to No genetic MHNo genetic MHMH problemsMH problems predispositionpredispositionAbusive upbringing Abusive upbringing NurturingNurturingPoor schoolsPoor schools Good schoolsGood schoolsPoor social supportPoor social support Good supportGood supportAvailable gamblingAvailable gambling Restricted gamesRestricted gamesSevere stressSevere stress Absence of stressAbsence of stressPoor coping skillsPoor coping skills Good copingGood coping
SubtypesSubtypes
ActionAction More likely to be More likely to be
malemale Prefer “skill” Prefer “skill”
gamesgames NarcissisticNarcissistic Uses gambling to Uses gambling to
elevate moodelevate mood
EscapeEscape More likely to be More likely to be
femalefemale Prefer “continuous” Prefer “continuous”
gamesgames Uses gambling to Uses gambling to
withdraw “zone withdraw “zone out”out”
Co-Occurring Disorders Among Co-Occurring Disorders Among PGsPGs
35-60% of PGs lifetime criteria for SA.35-60% of PGs lifetime criteria for SA. Alcohol:Alcohol: PGs average 4x higher lifetime PGs average 4x higher lifetime
abuse rate than non-gamblers. abuse rate than non-gamblers. Drugs:Drugs: PGs average 30% lifetime PGs average 30% lifetime
abuse/dependence (6% gen. pop.)abuse/dependence (6% gen. pop.) Tobacco:Tobacco: PGs average 55% lifetime PGs average 55% lifetime
dependence.dependence. SA associated with greater severity SA associated with greater severity
of PG.of PG.
PG in SA PopulationsPG in SA Populations
Tx Seeking SA have 2-10x rate of PG Tx Seeking SA have 2-10x rate of PG than general population.than general population.
Dual diagnosis (SA & PG) have more Dual diagnosis (SA & PG) have more severe consequences (legal, social, severe consequences (legal, social, family)family)
DD have more severe psychiatric DD have more severe psychiatric symptoms (ADD, ADHD, ASPD)symptoms (ADD, ADHD, ASPD)
Prevalence of MH Disorders Prevalence of MH Disorders
Gen PopGen Pop PGsPGs Tx Tx Seeking Seeking PGsPGs
Any Any DisorderDisorder
8%8% 40%40% 60%60%
Maj. Maj. DepressioDepressionn
5%5% 20%20% 60%60%
BipolarBipolar 1.5%1.5% 10%10% 15%15%
SuicidalitySuicidality 5%5% 20%20% 50%50%
Warning SignsWarning Signs
Preoccupation with gamblingPreoccupation with gambling Inability to set a limit/stick to itInability to set a limit/stick to it Borrowing from co-workers/friendsBorrowing from co-workers/friends Unexplained financial difficultiesUnexplained financial difficulties Substance abuse/mental health problemsSubstance abuse/mental health problems Suggestions by others the employee may Suggestions by others the employee may
have a gambling problemhave a gambling problem Mood swings due to winning and losing Mood swings due to winning and losing
streaksstreaks
More Warning SignsMore Warning SignsHenry Lesieur, Ph.D. observed the following Henry Lesieur, Ph.D. observed the following
workplace behaviors as being correlated with a workplace behaviors as being correlated with a gambling addiction:gambling addiction:
Excessive use of telephones (to call bookmakers Excessive use of telephones (to call bookmakers or obtain credit) or obtain credit)
Taking the company vehicle to the casino, etc. Taking the company vehicle to the casino, etc. (parking tickets near gambling locations are a (parking tickets near gambling locations are a "red flag”) "red flag”)
Arriving late (related to all-night card games, Arriving late (related to all-night card games, anxiety-related sleep disturbances) anxiety-related sleep disturbances)
Failure to take days off (obsessed with getting Failure to take days off (obsessed with getting money to pay gambling debts or afraid to leave money to pay gambling debts or afraid to leave because embezzlement or fraud may be because embezzlement or fraud may be discovered in their absence) discovered in their absence)
Organizing office pools and gambling junkets Organizing office pools and gambling junkets Embezzlement, defrauding customers Embezzlement, defrauding customers
Workplace GamblingWorkplace Gambling 19% of all workers (but 1/3 of 19% of all workers (but 1/3 of
professionals, business & financial services professionals, business & financial services workers) participated in March Madness workers) participated in March Madness pool, 24% paid more than $10 to enter pool, 24% paid more than $10 to enter (CareerBuilder.com, 2008)(CareerBuilder.com, 2008)
66% of callers to an EAP program 66% of callers to an EAP program indicated employees gamble in their indicated employees gamble in their workplace, 46% said it negatively impacts workplace, 46% said it negatively impacts productivity (hr.blr.com, 2006).productivity (hr.blr.com, 2006).
Casino employees have higher rates of Casino employees have higher rates of gambling problems, smoking, alcohol use gambling problems, smoking, alcohol use & depression (Am J Ind Med, 1999)& depression (Am J Ind Med, 1999)
Social CostSocial Cost Losses to individuals.Losses to individuals. Problem gamblers generate costs for Problem gamblers generate costs for
society—crime, bankruptcy, divorce, society—crime, bankruptcy, divorce, etc...etc...
U.S. National Gambling Impact Study U.S. National Gambling Impact Study Commission (1999): Commission (1999): $1,200 per adult pathological gambler.$1,200 per adult pathological gambler. $715 per adult problem gambler.$715 per adult problem gambler.
2008 U.S. Estimate: 2008 U.S. Estimate: $6.7 billion$6.7 billion
Treatment Works, If Treatment Works, If AvailableAvailable
Only about 1% of current pathological Only about 1% of current pathological gamblers seek treatment in a given gamblers seek treatment in a given year nationwide v. 20% of substance year nationwide v. 20% of substance abusers.abusers.
States with well funded PG programs States with well funded PG programs have much higher rates of treatment have much higher rates of treatment seeking (4% in OR, 4-10% in IA)seeking (4% in OR, 4-10% in IA)
IA: 61% abstinent at followup. IA: 61% abstinent at followup. OR: 63% not gambled for at least 6 OR: 63% not gambled for at least 6
mos at 1 year followup.mos at 1 year followup.
CounselingCounseling
Several national specialty Several national specialty certifications.certifications.
General state & national MH/SA General state & national MH/SA certifications do not include problem certifications do not include problem gambling training.gambling training.
Not routinely reimbursed by state or Not routinely reimbursed by state or private insurance (54% have private insurance (54% have coverage, but only 9% used it).coverage, but only 9% used it).
Life Skills & Help for Life Skills & Help for FamiliesFamilies
Prevention programsPrevention programs Financial guidesFinancial guides Conflict between GA pressure relief & Conflict between GA pressure relief &
credit counselingcredit counseling Some treatment programs include Some treatment programs include
family therapy.family therapy. Spouses can be liable for unpaid Spouses can be liable for unpaid
taxes on gambling winnings.taxes on gambling winnings.
PG Specific PG Specific Residential/InpatientResidential/Inpatient
10 centers (incl. VA) Less than 10 centers (incl. VA) Less than 100 beds for 3 million pathological 100 beds for 3 million pathological gamblers.gamblers.
Who is payor of last resort?Who is payor of last resort? VA 1 Year followup: 55% abstinent VA 1 Year followup: 55% abstinent
for 1 year + 27% abstinent at least for 1 year + 27% abstinent at least 1 month 1 month
Services ImplicationsServices Implications
Tx for PG may be less expensive than Tx for PG may be less expensive than substance abuse (no medical detox)substance abuse (no medical detox)
Majority seem to be effectively Majority seem to be effectively treated in outpatient settings.treated in outpatient settings.
Public/private partnerships are the Public/private partnerships are the dominant method of service delivery.dominant method of service delivery.
National Problem National Problem Gambling Gambling Awareness Week Awareness Week
March 2-8, 2009March 2-8, 2009
www.npgaw.orgwww.npgaw.org 50+ free 50+ free
materialsmaterials Screening toolsScreening tools PostersPosters FlyersFlyers BrochuresBrochures Press releasesPress releases StoriesStories
Section III: Youth Section III: Youth GamblingGambling
Kids Today…Kids Today… Increasing Majority of Youth Gamble Increasing Majority of Youth Gamble
(approximately 70% in past year, average (approximately 70% in past year, average prior to 1988 was 45%, between 1988 and prior to 1988 was 45%, between 1988 and 1999 65%)1999 65%)
First generation of kids to grow up with: First generation of kids to grow up with: unprecedented levels of legalized gambling (in unprecedented levels of legalized gambling (in
1976 less than a dozen states allowed gambling1976 less than a dozen states allowed gambling—48 plus more than 250 tribes today); —48 plus more than 250 tribes today);
pervasive promotion (state lotteries alone spent pervasive promotion (state lotteries alone spent $400 million on advertising in 1999);$400 million on advertising in 1999);
high rates of implicit parental endorsement high rates of implicit parental endorsement (over 50% gamble with family members, 78% (over 50% gamble with family members, 78% gamble in own homes)gamble in own homes)
Adults Adolescents College
Casino 14.9% 12.5% 60.8%
Lottery 49.0% 30.1% 60.1%
Sports 14.7% 30.6% 30.5%
Parimutuel 7.1% 11.2% 8.9%
Cards 15.8% 39.6% 36.1%
Skill Games 10.2% 31.6% 23.9%
Past Year Prevalence of Past Year Prevalence of GamblingGambling
Gambling Participation (14-Gambling Participation (14-17)17)
0%
5%
10%
15%
20%
25%
30%
35%
40%
2002 2003 2004 2005 2006 2007
Cards/ MonthAll Gamb/ MonthCards/ WeekAll Gamb/ Week
Gateway?Gateway?
May be the “gateway” activity as age May be the “gateway” activity as age of onset for gambling is earlier than of onset for gambling is earlier than all other risky behavior.all other risky behavior.
Youth who gamble have higher rates Youth who gamble have higher rates of substance use, drunk driving, of substance use, drunk driving, delinquency, sexual behavior and delinquency, sexual behavior and other antisocial behavior. other antisocial behavior.
Maybe it is because kids become Maybe it is because kids become accustomed to and enjoy risk taking accustomed to and enjoy risk taking learned in gambling? learned in gambling?
Youth Problem GamblingYouth Problem Gambling
Approximately 4-6% of youth (< 17) Approximately 4-6% of youth (< 17) meet criteria for a gambling problem.meet criteria for a gambling problem.
Risk factors include: male, low SES, Risk factors include: male, low SES, other risk taking behavior, other risk taking behavior, racial/ethnic minority.racial/ethnic minority.
Extremely low rate of Extremely low rate of awareness/treatment seeking. awareness/treatment seeking.
Early OnsetEarly Onset
All use starts recreationally, but may All use starts recreationally, but may lead to abuse.lead to abuse.
Earlier the age of onset for gambling, Earlier the age of onset for gambling, the greater risk for a gambling the greater risk for a gambling problem (pathological gamblers in problem (pathological gamblers in treatment report onset at 11 years). treatment report onset at 11 years).
BWI Airport, Across from Play BWI Airport, Across from Play AreaArea
Who Is Most Likely To Play Who Is Most Likely To Play Poker?Poker?
Annenberg SurveysAnnenberg Surveys 2.9 million youth play cards in 2.9 million youth play cards in
average week.average week. Monthly card playing jumped 20% Monthly card playing jumped 20%
to 42%. to 42%. 580,000 between 14 and 22 gamble 580,000 between 14 and 22 gamble
on Internet on a on Internet on a weeklyweekly basis. basis. 44% of weekly gamblers report 44% of weekly gamblers report
either preoccupation, over-either preoccupation, over-spending, tolerance or withdrawal. spending, tolerance or withdrawal.
Does Normal Brain Does Normal Brain Development Encourage Development Encourage Gambling (& Other Risky Gambling (& Other Risky
Behavior) ?Behavior) ?> risk taking (particularly in groups)> risk taking (particularly in groups)
> propensity toward low effort - high > propensity toward low effort - high excitement activitiesexcitement activities
< capacity for good judgment & < capacity for good judgment & weighing consequencesweighing consequences
> sensitivity to novel stimuli….> sensitivity to novel stimuli….
• Adolescence is a Adolescence is a period of period of profound brain profound brain maturation.maturation.
• It was believed It was believed
that brain that brain
development was development was
complete during complete during
childhoodchildhood
• The maturation The maturation
process is not process is not
complete until complete until
about age 24.about age 24.
Involvement in Addictive Involvement in Addictive BehaviorsBehaviors
Total useTotal use Weekly useWeekly use
7th7th 9th9th 11th11th 7th 7th 9th9th 11th11th
AlcoholAlcohol 37%37% 62%62% 80%80% 7% 7% 14%14% 20%20%
DrugsDrugs 4%4% 13%13% 27%27% 3% 3% 2% 2% 9% 9%
CigarettesCigarettes 18%18% 35%35% 48%48% 7% 7% 16%16% 31%31%
GamblingGambling 79%79% 79%79% 83%83% 30%30% 37%37% 37%37%
Kids have access to formal (credit cards), Kids have access to formal (credit cards), informal (bookies) and illegal (stealing) informal (bookies) and illegal (stealing) means of financing gambling.means of financing gambling.
Losses are “real” only when gambling Losses are “real” only when gambling stops, until then the problem gambler is stops, until then the problem gambler is just the next bet away from winning just the next bet away from winning everything back. everything back.
ProblemGambling
Chase Losses
Truancy/Delinquency
Stealing Money
Lying about
Gambling
Preference for
Gambling
Gamble to Escape
Gambling Problems
Family/Peer
Problems
The Good News: There is Hope The Good News: There is Hope and Helpand Help
While the majority of Americans While the majority of Americans gamble, most never develop problems.gamble, most never develop problems.
A total of 3-4% of the general A total of 3-4% of the general population will experience problems population will experience problems with their gambling in a given year. with their gambling in a given year.
PG often clusters with other problems. PG often clusters with other problems. PG is a treatable disorder, like all PG is a treatable disorder, like all
addiction most efficiently and addiction most efficiently and effectively when detected early. effectively when detected early.
National Council on National Council on Problem GamblingProblem Gambling
216 G Street, NE 2nd Floor216 G Street, NE 2nd FloorWashington, DC 20002Washington, DC 20002
Tel: 202.547.9204Tel: 202.547.9204Fax: 202.547.9206Fax: 202.547.9206
Email: Email: [email protected]@ncpgambling.org
Web: www.ncpgambling.orgWeb: www.ncpgambling.org